Japan Pancreatic Cancer Registry; 30th Year Anniversary: Japan Pancreas Society

OBJECTIVES: Since 1981, the Japan Pancreas Society has been hosting a nationwide pancreatic cancer registry. To commemorate its 30th anniversary, we review its history and latest achievement. METHODS: During 3 decades, more than 350 leading institutions in Japan contributed voluntarily to register and periodic follow-up. The registry was modified to protect privacy by encrypting and hash algorithm. RESULTS: From 1981 to 2007, 32,619 cumulative records were analyzed. The overall survival of invasive cancer was improved significantly. More patients with earlier stage or with intraductal and cystic neoplasms underwent resection. The strongest prognostic factor of Union for International Cancer Control (UICC) stage IIA and IIB tubular adenocarcinoma in the pancreatic head was histological grade, followed by tumor size, extent of lymph node dissection, and postoperative chemotherapy. The 5-year survival rate of Union for International Cancer Control stage 0 reached 85%. The improvement of survival of patients with invasive cancer in Japan can be attributed to the introduction of effective chemotherapies, regionalization, and the earlier diagnosis and treatment. Simple definition of "early pancreatic cancer" is needed. CONCLUSIONS: At the 30th year anniversary, the Japan Pancreas Society nationwide pancreatic cancer registry is more shining than ever for current perspectives and for future diagnostic and treatment tactics.     

Gemcitabine-induced Pleuropericardial Effusion in a Patient with Pancreatic Cancer

Pleuropericardial effusion is an extremely rare complication of gemcitabine chemotherapy. The patient was a 56-year-old woman administered systemic chemotherapy with gemcitabine for local recurrence of pancreatic cancer and lymph node metastasis developing 4 years after pancreaticoduodenectomy. Four months after the start of the chemotherapy, she presented with exertional dyspnea and edema in both her legs and face. Echocardiography and computed tomography revealed pericardial and bilateral pleural effusion. A pericardiocentesis was immediately performed to prevent the development of cardiac tamponade as well as to examine the cause of the pericardial effusion. As a result, the patient's exertional dyspnea and edema resolved. No metastases to the thorax or mediastinum were noted. A cytological study of the pericardial and pleural effusions revealed no malignant cells. Cultures for bacteria, mycobacteria and fungi were negative. Tests for autoantibodies indicating autoimmune disease were also negative, and hormonal assays for the detection of endocrine disease were normal. She was followed up after discontinuation of the gemcitabine treatment, and no further episodes of pericardial or pleural effusion occurred. Thus, it is speculated that the pericardial effusion and bilateral pleural effusion may have been caused by gemcitabine.